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Comment & Response
May 2018

Studies Omitted From the US Preventive Services Task Force Recommendations for Child Vision Screening—Reply

Author Affiliations
  • 1Vanderbilt Eye Institute, Nashville, Tennessee
JAMA Ophthalmol. 2018;136(5):600-601. doi:10.1001/jamaophthalmol.2018.0633

In Reply In writing an Editorial and selecting the articles to which Grossman, Curry, and Owens refer, my purpose was to demonstrate that similar evidence for vision screening exists for children younger than 3 years as exists for older children. The studies by Borchert et al1 and Cotter et al2 show that the prevalence of amblyopia risk factors (ARFs) in children younger than 3 years is similar to that of children aged 3 to 5 years. Longmuir et al3 compared the success rates of photoscreening in more than 210 000 Iowa children aged 3 to 5 years to the rate in children younger than 3 years. They found that the photoscreening referral rate for younger children was 3.3% and that the predictive value of a positive screen to have an ARF identified on formal eye examination was 86.6%; this was nearly identical to the 4.7% referral rate and 89.4% positive predictive value for children aged 3 to 5 years. Extrapolating prevalence values obtained from the referral rates and predictive values in Longmuir et al3 demonstrates that the Iowa photoscreening group identified children with ARFs at a rate similar to the percentages known to be present from the Borchert et al1 and Cotter et al2 studies. Thus, this information appears to support that photoscreening can identify children at risk for amblyopia just as efficiently in younger children as it can in older children.

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